A New-Designed Microwave Ablation System: Testing in ex vivo and in vivo Liver Model

doi:10.37015/AUDT.2021.200014

Abstract

Abstract:

Objective: The present study aimed to determine the efficacy and safety of a newly designed microwave ablation (MWA) system in ex vivo and in vivo liver model.
Methods: A new MWA system (HRMW-01, Hengrui Medical, Guangzhou, China) was tested on porcine liver ex vivo with different parameter settings (50-70 W for 5-20 min). Ablation volums were measured on the gross specimens. In an in vivo study, MWA was performed at 60 W for 5 min in canine liver. Ablation volumes were identified and measured using contrast-enhanced ultrasound (CEUS) 1 w after the ablation. All animals underwent routine hematological, biochemical, and coagulation tests before ablation at 1 d and 1 w after ablation. For comparison, radiofrequency ablation (RFA) was performed using a Cool-tip system (Valleylab, Boulder, CO, USA) with an automated power setting for 12 min in both ex vivo and in vivo studies.
Results: In ex vivo studies, the mean volumes of MWA coagulation ranged from 27.8 ± 7.3 cm³ to 144.6 ± 35.9 cm ³ and increased with ablation duration and power output. MWA was prone to creating larger volume but less spherical ablation shape than RFA (P < 0.05). In in vivo studies, MWA created larger ablation volumes with shorter ablation time compared to RFA (P < 0.05). Laboratory data showed significantly higher alanine aminotransferase and aspartate aminotransferase levels 1 d after ablation than based line levels (P < 0.05) while the levels decreased close to pre-ablation levels 1 w after ablation (P > 0.05).
Conclusion: The newly designed MWA system is safe and more efficient than a commonly used RFA system. However, further clinical studies are warranted.

Key words: Microwave ablation; Radiofrequency ablation; Liver; Contrast-enhanced ultrasound; Animal study

Danni He, MS, Qiao Ji, MD, Huitong Lin, MD, Xuankun Liang, MM, Lujing Li, MM, Fengping Liang, MM, Xianxiang Wang, MM, Kun Yuan, MS, Zuofeng Xu, MD. A New-Designed Microwave Ablation System: Testing in ex vivo and in vivo Liver Model. Advanced Ultrasound in Diagnosis and Therapy, 2021, 5(1): 39-46.

Figures/Tables 7

Figure 1

Table1

Figure 2

Table 2

Results of routine blood test, biochemical series and coagulation test before ablation, 1 d and 1 w after ablation in MWA and RFA"

Group	Time	WBC (10⁹/L)	RBC (10¹²/L)	Hb (g/L)	PLT (10⁹/L)	GLU (mmol/L)	Na (mmol/L)	K (mmol/L)	Cl (mmol/L)	CO₂ (mmol/L)	BUN (mmol/L)	CREA (μmol/L)	URIC (μmol/L)	BUN/CREA
MWA	Before	16.7 ± 1.5	7.2 ± 0.8	165.8 ± 15.8	375.4 ± 176.7	6.9 ± 4.1	145.2 ± 1.8	4.8 ± 0.4	109.6 ± 2.1	27.8 ± 3.3	3.8 ± 0.5	52.0 ± 7.3	25.8 ± 4.3	0.07 ± 0.01
	1 d	23.4 ± 9.9	7.3 ± 1.0	168.2 ± 23.8	324.8 ± 173.8	5.0 ± 1.5	145.8 ± 1.9	4.7 ± 0.3	111.2 ± 0.8	22.0 ± 2.2^*	4.8 ± 1.0	53.8 ± 7.8	61.2 ± 19.1^*	0.09 ± 0.01
	1 w	23.7 ± 5.9	6.9 ± 1.0	159.2 ± 24.3	390.2 ± 201.1	5.2 ± 0.6	144.8 ± 1.6	4.7 ± 0.2	108.6 ± 3.4	24.2 ± 2.5	3.4 ± 0.4	49.4 ± 11.2	23.8 ± 2.9^†	0.07 ± 0.02
RFA	Before	12.1 ± 2.3^§	7.1 ± 0.6	165.4 ± 15.3	259.0 ± 72.0	2.8 ± 0.6^§	145.6 ± 0.9	5.1 ± 0.3	112.4 ± 2.1	20.2 ± 1.3^§	4.3 ± 0.5	62.0 ± 9.1	41.8 ± 15.7	0.07 ± 0.00
	1 d	17.4 ± 5.1	6.7 ± 0.8	157.6 ± 20.7	237.8 ± 77.5	3.0 ± 1.9	144.4 ± 0.5	4.7 ± 0.4	109.8 ± 2.3	25.2 ± 3.4^*	4.3 ± 0.8	60.0 ± 11.5	42.0 ± 13.4	0.07 ± 0.01
	1 w	15.2 ± 3.7	7.0 ± 0.5	164.6 ± 14.9	334.2 ± 61.0	4.5 ± 0.8^‡	144.8 ± 0.4	4.5 ± 0.3	112.0 ± 4.2	21.6 ± 1.1	4.2 ± 0.8	53.6 ± 9.8	24.8 ± 1.5	0.08 ± 0.01
Group	Time	ALT (U/L)	AST (U/L)	LDH (U/L)	ALB (g/L)	GLB (g/L)	ALB/GLB	TP (g/L)	TBIL (μmol/L)	ALP (U/L)	PT (s)	INR	TT (s)	FIB (g/L)
MWA	Before	26.2 ± 5.4	44.8 ± 16.2	88.6 ± 17.4	30.7 ± 1.4	39.8 ± 8.8	0.8 ± 0.2	70.4 ± 7.7	0.2 ± 0.3	69.8 ± 26.3	7.5 ± 0.5	0.6 ± 0.0	16.5 ± 1.4	1.8 ± 0.8
	1 d	673.8 ± 330.8^*	427.2 ± 84.2^*	138.4 ± 25.0^*	32.1 ± 2.5	41.3 ± 4.9	0.8 ± 0.1	73.4 ± 2.6	1.3 ± 1.2^*	106.2 ± 52.1	8.3 ± 1.8	0.7 ± 0.2	17.3 ± 1.5	2.6 ± 0.4
	1 w	173.8 ± 96.3^†,‡	50.2 ± 11.7^†	104.6 ± 18.2	30.2 ± 1.8	41.3 ± 6.3	0.7 ± 0.2	71.4 ± 4.7	0.6 ± 0.2	84.8 ± 30.3	8.5 ± 3.1	0.7 ± 0.3	17.3 ± 1.7	2.3 ± 0.6
RFA	Before	32.8 ± 9.2	45.4 ± 6.1	160.4 ± 30.4^§	36.9 ± 13.3	34.2 ± 5.1	0.9 ± 0.1	65.1 ± 5.6	2.0 ± 1.4^§	50.6 ± 17.4	7.6 ± 0.9	0.7 ± 0.1	17.2 ± 1.8	1.5 ± 0.8
	1 d	722.6 ± 305.4^*	611.6 ± 290.6^*	162.4 ± 46.1	31.8 ± 2.2	33.9 ± 3.3^§	0.9 ± 0.1	65.8 ± 4.8	0.7 ± 0.6	138.4 ± 58.6^*	8.7 ± 3.6	0.7 ± 0.3	17.8 ± 1.6	2.9 ± 0.3^*
	1 w	307.8 ± 200.7^†,‡	47.2 ± 16.2^†	92.2 ± 30.2^†,‡	29.9 ± 1.2	34.3 ± 3.4^§	0.9 ± 0.1	64.2 ± 3.2^§	0.9 ± 0.4	80.2 ± 31.9	7.4 ± 1.0	0.6 ± 0.1	17.0 ± 0.7	2.4 ± 0.5

Table 2

Table 3

Figure 3

Figure 4

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Technical parameters and lesion diameters	MWA	RFA
Set power (W)	60	0-200
Ablation time (min)	5	12
Coagulation volume (cm³)	13.1 ± 1.5	10.0 ± 1.9 ^*
Shape index (long diameter/ short diameter)	1.37 ± 0.17	1.67 ± 0.29